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Published on: August 17, 2017
Racial and ethnic differences in hip fracture outcomes in men
Lucy H Liu, Malini Chandra, Joel R Gonzalez
1Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612.
Insights
Hip fracture incidence remained stable in older men, with white men experiencing the highest rates and Asian men the lowest. One-year mortality after hip fracture was similar for white, black, and Hispanic men, but significantly lower for Asian men.
Area of Science:
- Gerontology
- Orthopedics
- Epidemiology
Background:
- Hip fractures are a significant health concern for older adults, leading to increased morbidity and mortality.
- Understanding temporal trends and racial/ethnic disparities in hip fracture incidence and outcomes is crucial for targeted public health interventions.
Purpose of the Study:
- To analyze temporal trends in hip fracture incidence among older men.
- To investigate racial and ethnic differences in hip fracture incidence and associated mortality in older men.
Main Methods:
- A retrospective cohort study was conducted using data from a diverse northern California healthcare population.
- Hip fracture incidence and all-cause mortality within 12 months post-fracture were examined in men aged 50 years and older from 2000 to 2010.
- Data were analyzed to compare incidence and mortality rates across different racial and ethnic groups, adjusting for age and comorbidity index.
Main Results:
- The age-adjusted annual incidence of hip fracture averaged 127 per 100,000 men, with rates highest in white men and lowest in Asian men in 2010.
- One-year mortality following hip fracture was 33.7% for white, 32.4% for black, 31.1% for Hispanic, and 23.1% for Asian men (P < .05).
- Asian men had significantly lower mortality risk (adjusted odds ratio, 0.62) compared to white men after adjusting for relevant factors.
Conclusions:
- Hip fracture incidence rates were relatively stable among older men during the study period.
- While incidence was highest in white men, Asian men demonstrated a significantly lower mortality risk post-hip fracture compared to white men.
- Further research is warranted to elucidate the factors contributing to the observed ethnic variations in hip fracture outcomes among US men.
Objectives:
To examine temporal trends and racial/ethnic differences in hip fracture incidence and mortality outcome in older men.
Study Design:
Retrospective cohort study.
Methods:
We ascertained men 50 years or older with a hip fracture during 2000 to 2010 in a diverse northern California healthcare population. Age, comorbidity index, hip fracture incidence, and all-cause mortality up to 12 months post fracture were examined and compared by race/ethnicity.
Results:
A total of 6247 men (aged 79.3 ± 9.8 years) experienced a hip fracture during 2000 to 2010: 81.4% were white, 7.5% Hispanic, 3.8% black, and 3.9% Asian. The age-adjusted annual incidence of hip fracture averaged 127 per 100,000, ranging from 116 to 139 per 100,000 during this period. In 2010, the age-adjusted incidence of hip fracture was highest among white men (137), followed by Hispanic (98) and black (80), and was lowest among Asian men (45 per 100,000). Mortality following hip fracture was 11.1%, 19.8%, 25.4%, and 32.9%, within 1, 3, 6, and 12 months, respectively, and increased with age. One-year mortality was similar for whites (33.7%), blacks (32.4%), and Hispanics (31.1%), but lower for Asians (23.1%; P <.05). Adjusting for age, comorbidity index, and calendar year, Asians remained at lower mortality risk compared with whites (adjusted odds ratio, 0.62; 95% confidence interval, 0.45-0.86).
Conclusions:
Although hip fracture rates were largely stable among older men, contemporary rates of hip fracture were highest for white and lowest for Asian men. One-year mortality was similar for white, black, and Hispanic men, but significantly lower for Asians. Future studies should investigate factors underlying observed ethnic differences in fracture outcome among US men.
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